Organization
NEW MEXICO SURGICAL ASSISTING, INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
VALERIANE M WILSON (PRESIDENT/DIRECTOR)
(505) 991-5713
Entity
Organization
Contact information
Practice address
1505 KACHINA RIDGE DR, SANTA FE, NM 87507-5172
(505) 463-5645
(888) 816-6104
Mailing address
PO BOX 23974, SANTA FE, NM 87502-3974
(505) 463-5645
(888) 816-6104
Taxonomy
Speciality
Code
Description
License number
State
363AS0400X
Surgical Physician Assistant
Primary
PA2005-0035
NM
Other
Enumeration date
01/15/2011
Last updated
01/15/2011
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